We examined occupational exposures among subjects with sinonasal cancer (SNC) recorded in a population-based registry in the Lombardy Region, the most populated and industrialized Italian region. The registry collects complete clinical information and exposure to carcinogens regarding all SNC cases occurring in the population of the region. In the period 2008–2011, we recorded 210 SNC cases (137 men, 73 women). The most frequent occupational exposures were to wood (44 cases, 21.0%) and leather dust (29 cases, 13.8%), especially among men: 39 cases (28.5%) to wood and 23 cases (16.8%) to leather dust. Exposure to other agents was infrequent (<2%). Among 62 subjects with adenocarcinoma, 50% had been exposed to wood dust and 30.7% to leather dust. The proportions were around 10% in subjects with squamous cell carcinoma and about 20% for tumors with another histology. The age-standardized rates (×100,000 person-years) were 0.7 in men and 0.3 in women. Complete collection of cases and their occupational history through a specialized cancer registry is fundamental to accurately monitor SNC occurrence in a population and to uncover exposure to carcinogens in different industrial sectors, even those not considered as posing a high risk of SNC, and also in extraoccupational settings. 1. Introduction Cancer of the nasal cavity and the paranasal sinuses, referred to as “sinonasal cancer” (SNC), is relatively uncommon in the general population, accounting for less than 1% of all neoplasms and less than 4% of those arising in the head and neck region [1–3]. SNC incidence is around 1 × 100,000 person-years in most developed countries [4]. In the period 1998–2002, the annual incidence rates in the United States were 0.8 and 0.6 × 100,000 in males and females, respectively [5]. In the same period, the RARECARE project, based on about 2200 cases of epithelial tumors of nasal cavities in Europe, showed an age-standardized rate of 0.36 × 100,000 [6]. The incidence rates in 1998–2002 estimated by the Italian network of cancer registries (Associazione Italiana Registri Tumori, AIRTUM, http://www.registri-tumori.it/), which covers 40% of the whole population, were between 0.4 and 2.0 in males and 0.1 and 0.5 × 100,000 in females, with about 300 cases expected per year in the whole country; a high variability across Italian regions was reported. Frequency, anatomical site, and histological type of SNCs vary across geographical areas due to several factors [3]. A history of chronic sinusitis, nasal polyps [7], use of nasal drug preparations, and smoking and occupational
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